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Final Flashcards

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1
Q

CN I

A

Olfactory (smell)

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2
Q

CN II

A

Optic (vision)

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3
Q

CN III

A

Oculomotor (EOM, raise eyelids, pupil constriction, lens shape)

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4
Q

CN IV

A

Trochlear (inward and downward movement of the eye)

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5
Q

CN V

A

Trigeminal (Muscles of mastication, sensation of the face and scalp, cornea, mucous membranes of mouth and nose)

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6
Q

CN VI

A

Abducens (lateral movement of the eye)

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7
Q

CN VII

A

Facial (facial muscles, close eyes, speech, taste, saliva and tear excretion)

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8
Q

CN VIII

A

Acoustic (hearing)

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9
Q

CN IX

A

Glossopharyngeal (phonation and swallowing, taste, gag reflex)

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10
Q

CN X

A

Vagus ( talking/swallowing, carotid reflex, pharynx)

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11
Q

CN XI

A

Spinal (movement of trapezius and sternomastoid muscles)

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12
Q

CN XII

A

Hypiglossal (movement of the tongue)

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13
Q

Causes of seizres

A 
Cerebrovascular disease
Hypoxemia of any cause
Fever (childhood)
HTN
CNS infections
Metabolic/toxic condition
Drug/alcohol withdrawal 
Allergies
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14
Q

Characteristics of Grand Mal seizure (tonic clonic)

A

Last about 2 minutes
Aura occurs
Muscle contraction, periods of apnea (tonic)
Excessive salivation, forceful movement of extremities, rapid pulse (clonic)
Possible incontinence
Stupor 5-10 min following clonic phase

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15
Q

Characteristics of Petit Mal seizure (Absent seizure)

A 
Small movement of face or eyes
Staring into space
Last for few seconds to a min
Occur mostly in children 
Dulling of consciousness 
Usually no falling
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16
Q

Characteristics of Jacksonian seizure

A

Begins with one part of the body (twitching of one side of face of abnormal movement of one hand)

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17
Q

Characteristics of complex seizure

A

Pt exhibits altered behaviors, unusual sensation (not aware of it)

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18
Q

Nursing care during a seizure

A
  • Provide privacy
  • Aura occurs?
  • Ease pt to floor
  • Push aside furniture
  • Loosen constrictive clothing
  • Remove pillows/raise side rails
  • Note where in the body the seizure began
  • Any incontinence?
  • Duration of seizure?
  • Don’t attempt to pry open jaws
  • Do not restrain pt
  • Place pt on one side
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19
Q

Nursing care after a seizure

A
  • Keep pt on side to prevent aspiration
  • Pt should be reoriented
  • Document event leading to and occurring before/after
  • Maintain airway
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20
Q

What is status elipticus?

A

A series of generalized seizures that occur w/o full recovery of consciousness b/w attacks

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21
Q

Medical management of status elilepticus

A
  • Stop the seizure as quickly as possible
  • Airway and adequate O2
  • IV Valium, Cerebryx given slowly
  • Blood samples
  • EEG
  • Neuro checks
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22
Q

Division of the Peripheral nervous system

A

Autonomic (involuntary efferent)

Somatic (stimulates voluntary muscles)

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23
Q

Division of autonomic system

A

Parasympathetic (Rest and digest)

Sympathetic (Fight or flight)

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24
Q

Functions of the frontal lobe

A 
Voluntary movement 
Personality/Mood
initiative/judgement 
Planning
Social behavior
Bladder control 
Concentration
Broca's area (motor control of speech)
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25
Q

Functions of the parietal lobe

A 
Attention to stimuli
Dressing
Drawing
Feeling shape and texture
Spatial imaging
Finding one's way around
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26
Q

Functions of occipital lobe

A

Interpreting vision

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27
Q

Functions of temporal lobe

A 
Visual memory 
Facial recognition
Music appreciation
Hearing 
Mood (aggression)
Non-language
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28
Q

Dizziness

A

A sensation of imbalance or movement. Can be caused by viral syndromes, hot weather, roller coaster rides, and middle ear infections

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29
Q

Vertigo

A

The illusion of movement

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30
Q

Normal range of ICP

A

10-20mm Hg

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31
Q

Patho of increased ICP

A

Cerebral bl flow decreases, which results in ischemia and cell death. A sympathetic response is activated which causes a subsequent increase in BP. The increased BP then activates the parasympathetic system via carotid artery baroreceptors resulting in a vagal induced bradycardia. (Cushings reflex)

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32
Q

Signs of increased ICP (Cushings triad)

A

Increase in BP
Bradycardia
Bradypnea

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33
Q

Difference between shock and Cushing’s triad

A

In shock there is a decrease in BP, and increase in respirations and pulse

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34
Q

Manifestations of worsening ICP

A 
Changes in LOC 
Restlessness w/o cause
Confusion, increasing drowsiness
Pt may only react to only loud or painful stimuli
Decorticate or decerebrate
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35
Q

Patho of migraines

A

Often hereditary, associated w/ low Mg levels in brain
Attacks can be triggered by hormonal changes associated with menstrual cycle, bright lights, stress, depression, sleep deprivation, fatigue and odors. Foods containing tyramine (aged cheese), nitrates or milk products may trigger attack.

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36
Q

What occurs in the aura phase of a migraine?

A

Lasts less than 1 hr, enough time for pt to take medication, Visual disturbances may occur, and may be hemianopic. Numbness and tingling of the lips, face or hands, mild confusion, sllight weakness of an extremity, drowsiness and dizziness may occur.

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37
Q

What are the 5 categories of a neuro assessment?

A 
Consciousness and cognition
Cranial nerves
Motor system (muscle tone, atrophy)
Sensory system (sensation, pain?)
Reflexes
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38
Q

3 parts of the Glasgow coma scale

A

Eye movement
Verbal response
Motor response

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39
Q

A 3 in the glasgow coma scale section of motor response indicates what type of positioning?

A

Decorticate

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40
Q

A 2 in the glasgow coma scale section of motor response indicates what type of positioning?

A

Decerebrate

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41
Q

Characteristics of left hemispheric stroke

A

Slow cautious behavior
Aphasia (expressive, receptive or global)
Altered intellectual ability
Right visual field deficit
Paralysis or weakness on the right side of the body

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42
Q

Characteristics of right hemispheric stroke

A

Lack of awareness of deficits
Left visual field deficit
Impulsive behavior
Increased distractibility
Paralysis or weakness on the left side of the body
Spatial-perceptual deficit; trouble learning to care for themselves

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43
Q

Criteria for t-PA

A
  • 18years old<
  • Clinical dx of ischemic stroke
  • Systolic <15sec
  • Not received heparin during last 48hrs
  • No prior intracranial bleed, AVM, neoplasm or procedure
  • No major surgical procedures within days
  • No stroke, serious head injury, or intracranial surgery within the last 3 months
  • No GI or urinary bleeding within days
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44
Q

Characteristics of Type 1 diabetes

A 
Body does not make insulin
Autoimmune response
Normal weight
Glucose remains in the bl stream
Production of ketones
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45
Q

Characteristics of of type 2 diabetes

A

Insulin resistance (insulin is not as effective)
Impaired insulin secretion
Obesity
More common in adults

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46
Q

S/S of hyperglycemia (hot and dry, blood sugar high)

A 
Extreme thirst
Frequent urination
Dry skin
Hunger
Blurred vision
Drowsiness
Decreased healing
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47
Q

Causes of hyperglycemia

A 
Too much food
Too little insulin 
Illness
Stress
Gradual onset
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48
Q

S/S of hypoglycemia (cold and clammy, need some candy)

A 
Shaking
Tachycardia
Sweating
Dizziness
Anxiety
Hunger
Impaired vision
Weakness/fatigue
HA
Irritability
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49
Q

Yearly screenings for pts with diabetes

A

-Cholesterol check annually
-Dental exam 2x a year
-Foot check w/ Dr every visit
-Thorough foot exam annually
-Urine check for kidney damage (microalbumin) annually
Pneumonia vaccine and flu shot annually
-Dilated eye exam with ophthalmologist annually

50
Q

Foot care for a pt with diabetes

A 
Look for cuts, blisters, red spots, and swelling.
Wash feet everyday in warm water
Dry well, b/w toes 
Keep feet smooth and soft 
Trim toenails weekly 
Avoid contact with hot surfaces
Elevate feet when sitting, avoid crossing legs
Never walk barefoot
51
Q

How is diabetes diagnosed

A

Hx of the 3 P’s
Fasting bl glucose < twice
GTT
A1C higher than 7%

52
Q

Educating pt on insulin

A 
Refrigerate
Do not freeze or keep in heat
Keep at room temp once opened 
Never inject cloudy into clear 
Do not use exact same site 
Insulin should not be injected into limb that will be exercised
53
Q

Diabetic ketoacidosis is caused by

A

An absence or inadequate amount of insulin resulting in disorders in the metabolism of carbs, proteins, and fats

54
Q

Main sx of DKA

A 
hyperglycemia
Dehydration and electrolyte loss
Acidosis 
Acetone breath 
Polyuria
Polydipsia
Fatigue
Blurred vision
Weakness
HA
55
Q

Patho of DKA

A

W/o insulin, the amount of glucose entering the cells is reduced. The release of glucose by the liver is increased causing hyperglycemia. To rid the body of excess glucose the kidneys excrete it with water and electrolytes. Polyuria leads to dehydration. Free fatty acids are converted into ketone bodies by the liver.

56
Q

What is hyperglycemic hyperosmolar syndrome?

A

Metabolic disorder of type 2 diabetes resulting from a relative insulin deficiency initiated by an illness that raises the demand for insulin

57
Q

Difference b/w DKA and HHS

A

In DKA there is no insulin present. In HHS insulin is too low to prevent hyperglycemia but high enough to prevent fat breakdown. Acidosis doesn’t occur in HHS

58
Q

Sx of HHS

A 
Hypotension
Profound dehydration
Tachycardia
Altered LOC
Seizures
59
Q

Stroke volume

A

Amount of blood ejected with each heartbeat

60
Q

Cardiac output

A

Amount of blood pumped by ventricle in liters per minute

61
Q

Preload

A

Degree of stretch of cardiac muscle fibers at the end of diastole

62
Q

Contractility

A

Ability of cardiac muscle to shorten in response to electrical impulse

63
Q

Afterload

A

Resistance to ejection of blood from ventricle

64
Q

Ejection fraction

A

Percent of end diastolic volume ejected with each heart beat

65
Q

Sx of left sided heart failure

A 
Crackles
Dyspnea
Dry cough 
Orthopnea
Diminished CO
Oliguria
66
Q

Sx of right sided heart failure

A 
JVD
Edema of lower extremities
Hepatomegaly
Ascites 
Generalized weakness
67
Q

Stable angina

A

Predictable and consistent pain that occurs on exertion and is relieved by rest of NTG

68
Q

Unstable angina (Preinfaction angina)

A

Sx increase in frequency and severity, may not be relieved by rest or NTG

69
Q

Intractable (refractory) angina

A

Severe incapacitating chest pain

70
Q

Variant angina

A

pain at rest with reversible ST segment elevation

71
Q

Silent ischemia

A

Objective evidence of ischemia but pt reports no pain

72
Q

What is Raynuads phenomenon?

A

A form of intermittent arteriolar vasoconstriction that results in the coldness, pain and pallor of the fingertips or toes. Most common in women

73
Q

Sx of DVT

A

Edema and swelling of the extremity b/c of the outflow of venous blood is inhibited. The affected extremity may be warmer, tenderness

74
Q

What medication should be given to increase contractility in patients with heart failure?

A

Digoxin

75
Q

To decrease afterload, what meds should be given?

A

Vasodialator
Nitroglycerin
Ca+ channel blockers
Beta blockers

76
Q

ST segment is depressed with

A

Ischemia

77
Q

ST segment is elevated with

A

MI, cardiac injury

78
Q

What is primary HTN?

A

High BP from an unidentified cause, most common

79
Q

What is hypertensive emergency?

A

BP is extremely elevated and must be lowered immediately to prevent damage to target organs. Goal is to reduce pressure by 20-25% within the first hour

80
Q

What is hypertensive urgency?

A

BP is very elevated but there is no evidence of impending or progressive target organ damage.. Associated with severe headaches, nosebleeds, or anxiety. ACE inhibitors and beta blockers are used to treat.

81
Q

What is metabolic syndrome?

A

A cluster of conditions that occur together, increasing your risk of heart disease, stroke and diabetes.

82
Q

EKG changes that occur with an MI

A

T wave inversion
ST elevation
Abnormal Q-wave

83
Q

STEMI

A

Patient has ekg with evidence of acute MI with characteristic changes in two contiguous leads on a 12 lead. In this type of MI, there is significant damage to the myocardium

84
Q

NSTEMI

A

The pt has elevated cardiac biomarkers but no definite EKG evidence of acute MI. In this type of MI there may be less damage to the myocardium.

85
Q

Characteristics of arterial circulatory insufficiency

A 
Diminished/absent pulses
Cool/cold skin
Loss of hair over toes
Dry shiny skin 
Deep, circular ulcer
Minimal leg edema
Very painful
Intermittent claudication
86
Q

Characteristics of venous insufficiency

A 
Present but difficult to palpate pulses thru edema
Skin thickened 
Reddish blue skin
Minimal pain 
Irregular border ulcer
Moderate to severe leg edema
Aching and cramping
87
Q

What is Buergers disease?

A

Rare disease characterized by the obstruction of blood vessels in the hands and feet, reducing the availability of blood to the tissues causing pain and eventually damages the tissue

88
Q

Sx of Beurgers disease

A 
Pain/tenderness
Numbness and tingling in limb
Skin ulcer or gangrene of the digits
Discoloration
Pain may increase w/ activity 
Pulse may be decreased in affected extremity
89
Q

Sulfonylureas

Glyburide, Glipizide

A

Tell the pancreas to make more insulin

90
Q

Metformin

A

Tells the liver to stop sending out sugar

91
Q

Glitazones

Avandia and Actos

A

Help insulin in the body work better

92
Q

Meglitinides

Prandin, Starlix

A

Tell the pancreas to make more insulin. Taken with meals

93
Q

Alpha-glucosidase inhibitors

Precose, Glyset

A

Slow down the absorption of cabs from the intestines after you eat

94
Q

Droplet Precautions

A

Ex: Meningitis, pneumonia, influenza, mumps, rubella
Mask and private room
Doors may remain open

95
Q

Airborne precautions

A

Ex: TB, measles, chickenpox
Private negative pressure room
Keep doors closed

96
Q

Contact precautions

A

Most frequent mode of transmission
Ex: Hep A, herpes, C.Diff
Gloves, gown, private room in addition to standard precautions

97
Q

What is Dumping syndrome?

A

Response to rapid emptying of gastric contents into the small intestine

98
Q

Sx of dumping syndrome?

A 
Fullness
Weakness
Faintness
Dizziness
Palpitations
Cramping pain
Nausea
Sweating 
Diarrhea
99
Q

Melena

A

Tarry or black stools: indicative of occult blood in stools

100
Q

Psoas sign

A

Right hand above right knee, raise leg against resistance, flexion of hip causes contraction of psoas muscle. appendicitis?

101
Q

Chain of infection

A 
Infectious agent
Resevoir
Portal of exit
mode of transmission
Portal of entry
Susceptible host
102
Q

Blumberg’s sign

A

Abdominal wall is compressed slowly and then rapidly released. Indicative of peritonitis

103
Q

Rovsing’s sign

A

Pain in RLQ during pressure in LLQ. Sign of appendicitis, or peritoneal irritation

104
Q

Murphy’s sign

A

Palpate liver while pt take in deep breath. Sharp pain with no inhalation
Possible cholecystitis

105
Q

What is gastritis?

A

Inflammation of the gastric stomach mucosa

106
Q

S/S of acute gastritis

A 
Abdominal discomfort
HA
N/V
Lassitude  
Hiccuping
107
Q

S/S of chronic gastritis

A 
Melena
Blood in vomit
Anorexia
Heartburn after eating
Belching
Sour taste in mouth 
N/V
Malabsorption on B12
108
Q

Malabsorption of B12 leads to

A

Pernicious anemia

109
Q

What is Peptic ulcer disease

A

An excavation that forms in the mucosal wall of the stomach, pylorus, duodenum, or the esophagus

110
Q

Patho of PUD

A

Erosion is caused by the increased concentration of acid-pepsin or by decreased resistance of the mucosa. A damaged mucosa cannot secrete enough mucus to act as a barrier against HCl

111
Q

S/S of duodenal PUD

A 
Pain is relieved by food 
Melena
Pain commonly occurs 2-3hrs after meals 
Awake with pain during the night 
No weight loss
112
Q

S/S of gastric PUD

A

Food does not relieve pain
Pain occurs immediately after eating
Hematemesis

113
Q

Medication used to treat ulcers from H.pylori

A

Antibiotic (Flagyl, amoxicillin)
Proton pump inhibitor (-prazole)
Bismuth salts (pepto bismol)

114
Q

Medication used to treat non h.pylori ulcers

A

H2 receptor antagonist (Pepcid, Zantac)

PPI (-prazole)

115
Q

What do Proton pump inhibitors do?

A

Decrease gastric secretion by slowing the pump on the parietal cells

116
Q

What do H2 receptor antagonists do?

A

Decrease the amount of HCl produced by the stomach by blocking action of histamine on histamine receptor of parietal cells in the stomach

117
Q

What is Crohn’s disease?

A

A subacute and chronic inflammation of the GI tract wall that extends thru all layers, most commonly occurs in the distal ileum

118
Q

S/S of Crohns disease

A 
RLQ pain 
Diarrhea  
Abdominal tenderness/spasm
Cramping occurs after meals
Weight loss
Malnutrition 
anorexia
N/V
Anemia 
Dehydration
119
Q

What is ulcerative colitis?

A

Recurrent ulcerative and inflammatory disease of the mucosal and submucosal layers of the colon and rectum

120
Q

S/S of ulcerative colitis

A 
LLQ pain 
Passage of mucus and pus
Diarrhea (10-20 liquid stools)
Rectal bleeding 
Weight loss
Anorexia
Anemia
Fever 
Vomiting
Dehydration

Fundamentals of Nursing (12 decks)

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